Organization
COASTAL ORTHODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE T ROGERS (OFFICE MANAGER)
(985) 853-1142
Entity
Organization
Contact information
Practice address
635 ENTERPRISE DRIVE, HOUMA, LA 70360-7036
(985) 853-1142
(985) 853-1143
Mailing address
PO BOX 20068, HOUMA, LA 70360-0068
(985) 853-1142
(985) 853-1143
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
01/29/2019
Last updated
01/14/2020
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